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A Historical Overview of the Therapeutic Use of Bacteriophages

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A historical overview of the therapeutic use of bacteriophages Andrzej Górski ¹ ², Beata Weber-Dąbrowska ¹, Ryszard Międzybrodzki ¹ ², Jan Borysowski ² ¹ Bacteriophage Laboratory & Therapy Center, L.Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wrocław, Poland ² Department of Clinical Immunology, T.Orlowski Transplantation Institute, The Medical University of Warsaw, 02-006 Warsaw, Poland The milestones in phage history Elbreki et al., 2014, Journal of Viruses ,vol.2014, Article ID 382539 Hankin published his observations in 1896 in the annals of the Institut Pasteur – that was the first evidence of the presence of bacteriophages in water and their antibacterial activities. It was a viral-like agent with antibacterial properties. It was temperature sensitive and capable of passing through a porcelain filter, and it could reduce titres of the bacterium Vibrio cholerae in laboratory cultures. "L'action bactericide des eaux de la Jumna et du Gange sur le vibrion du cholera„ Annales de l'Institut Pasteur (in French) 1896; 10: 511–523. In 1915 The Lancet published an article written by Frederick Twort about ‘‘the transmissible bacterial lyses’’. It was the first publication on bacteriophages. The Lancet, Jan. 10th, 1914, p. 101 Courtesy of Ms Grace Philby Courtesy of Ms Grace Philby Felix d'Herelle In 1917 Félix d’Herelle isolated first bacteriophages from the stools of patients recovering from dysentery*. He supposed that bacteriophages were agents that cause natural recoveries*. He showed that bacteriophages could be used to treat bacterial infections in humans*. Felix d'Herelle at a bacteriophage Bacteriophages have been used in research center. medicine since 1919, ten years .Thacker PD. (2003) Set a microbe to kill a microbe: drug before the discovery of the penicillin resistance renews interest in phage therapy. – the first antibiotic*. JAMA;290(24):3183-5. *http://www.pasteur.fr/en/brief-history-bacteriophages In 1917 d’Herelle and co-workers isolated phages with lytic activity against pathogenic bacteria: Escherichia coli, Neisseria meningitis, Pasteurella multocida, Pseudomonas aeruginosa, Salmonella typhi, Shigella dysenteriae, Streptococcus species, Vibrio cholerae, Yersinia pestis. He developed the idea of ”phage therapy” as prophylactic and/or therapeutic use of selected bacteriophages in the destruction of pathogenic bacterial cells while remaining completely innocuous to host cells (d`Herelle, 1923). For this idea he deserved the Noble Prize, to which he was nominated eight times (every year since 1925), although he was never awarded one. Fruciano D.E., Bourne S.(2007) Can J Infect Dis Med Microbiol. 18(1): 19–26. http://www.pasteur.fr/ip/portal/action/WebdriveActionEv ent/oid/01s-00002q-016 Hankin EH. L'action bactericide des eaux de la Jumna at du Gange sur le vibrion du cholere. Ann Int Pasteur (Paris) 1896,10,511-23. Twort TW. An investigation on the nature of ultramicroscopic viruses. Lancet 1915,186,1241-3. d'Herelle F. Sur un microbe invisible antagoniste des baccilles dysenteriques. CR Acad Sci Paris 1917,163,173-5. I Co-discovery of phages: 1915 F.Twort, 1917 F. d’Herelle II 1920 – 1934 high expectations 1921 – first article on phage therapy: Bruynoghe, R. and Maisin, J., Essais de thérapeutique au moyen du bactériophage du Staphylocoque, J Compt Rend Soc Biol 85, 1120-1121, 1921.4 (Staph skin infections) III 1934 - critical review of the available literature on phage therapy, conclusions not in favor of the therapy (phage effect = enzyme) Eaton MD, Bayne-Jones S. JAMA 1934,103,1769-76. IV Displacement of phage therapy after WWII by antibiotics V Phage therapy “rediscovered” by the English literature Smith, H. W. Huggins, M. B. Successful treatment of experimental Escherichia coli infections in mice using phage: its general superiority over antibiotics. J Gen Microbiol 1982, 128, 307–318. France 1919 – early 1990 (Pasteur Institute in Lyon) D’Herelle tested safety of phage preparations on himself, family and colleagues (orally and injections), no ill effects. A boy with a severe dysentery – the symptoms ceased after a single administration of phage Hopital des Enfants Malades, Paris, 1919 (unpublished) 1916 – 30 d’Herelle in China, Laos, India, Vietnam, Africa combating epidemics of cholera and plague 1931 – first intravenous use (d’Herelle, treatment of cholera in India) Staph bacteriemia, 1 hr iv infusion USA 1920 – 30s Eli Lilly, Abbott Laboratories sterile phage lysates Discouraging JAMA report (based on > 100 studies of phage therapy), except staph infections and cystitis Eaton M.D., Bayne-Jones S. Bacteriophage therapy. JAMA 1934,103;1769-76 MacNeal W., Frisbee F. One hundred patients with Staphylococcus septicaemia receiving bacteriophage service. Am. J. Med. Sci. 1936;191:179–195. doi: 10.1097/00000441- 193602000-00004 1936 – 40 typhoid patients, Los Angeles area 1950 – 1994 Staph Phage Lysate (SPA) (Delmont Labs) intranasally, topically, orally, sc iv only minor side effects 1987 A veterinary license for SPL, clinical effe4icacy confirmed in dogs by clinical trial Clinical trial in the Czech Republic (Stafal, 1992-94) registered in the Czech Republic and Slovakia for the topical treatment of Staph. skin infections Georgia Eliava Institute In Tbilisi, established in 1930 by Eliava and d’Herelle 1980: 1200 employees, production capacity: 2 tons /week (Kutter et al., Curr Pharm Biotechnol 2010,11,69) Tablets, liquid (in the past 80% for the Soviet Army) Complex cocktails: Pyophage (S,aureus, E.coli, P.aeruginosa, Proteus, Streptococcus) Intestiphage (23 different enteric bacteria) Russia 1920s – currently Vestn Otorinolaringol. 2015;80(1):80-3. [Prospects for the application of bacteriophages in otorhinolaryngology]. [Article in Russian] Nosulya EV. Abstract The objective of the present work was to summarize the available literature data concerning the importance of and prospects for for the application ofbacteriophages for the treatment of the most common diseases of the upper respiratory tract and the ear. PMID: 26003968 [PubMed - in process] Brazil : Institute Oswaldo Cruz 1924 - ? (anti-dysentery phage) Romania 1960s (synergism with antibiotics) Military use The Finnish Campaign (1939-40) Afrika Korps 1941-43 Soviet – German war 1941-45 Poland 1920s – 2015 1945 – 54 L.Hirszfeld establishment of phage bank, Institute of Immunology and Experimental Therapy, PAS 1954 – 1987 Slopek, > 1000 pts 84-97% success rate reported 2005 – establishment of phage therapy unit (compassionate use based on Declaration of Helsinki and relevant Polish legislation (Constitution of Poland, act on the profession on doctors, ethical code of the Polish Medical Association) Ludwik Hirszfeld (1884-1954), one of the most prominent serologists of the twentieth century, established the nomenclature and the inheritance of blood groups, and opened the field of human population genetics. He also carried out groundbreaking researchin the genetics of disease and immunology. Following World War II, he founded Poland's first Institute of Immunology in Wroclaw, which now bears his name. His autobiographical memoir, The Story of One Life, first published in Poland in 1946, immediately became a bestseller and has been reedited several times since. It is an outstanding account of a Holocaust survivor and a writer capable of depicting the uniqueness and the tragedy of countless individuals caught up in the nightmare of 1939-45. Herecollects his time as a physician in the Serbian army in 1915 and his satisfaction as one of the scientific elite who Eds: MA Balińska, WH Schneider rebuilt Poland … University of Rochester Press, 2010 Attempts to use bacteriophagy in surgery Polish Medical Journal 1927,6,67 1. Ślopek S., Weber-Dąbrowska B., Dąbrowski M., Kucharewicz-Krukowska A.: Results of bacteriophage treatment of suppurative bacterial infections in the years 1981-1986. Arch Immunol Ther Exp 1987; 35: 569-583. (550 cases were analyzed) 2. Ślopek S., Kucharewicz-Krukowska A. Weber- Dąbrowska B., Dąbrowski M.: Results of bacteriophage treatment of suppurative bacterial infections. V. Evaluation of the results obtained in children. Arch Immunol Ther Exp 1985; 33: 241-259. (114 cases were analyzed) 3. Weber-Dąbrowska B., Mulczyk M., Górski A.: Bacteriophage therapy of bacterial infections: an update of our Institute`s experience. Arch Immunol Ther Exp 2000; 48: 547-551. (the results of the phage treatment of 1307 patients were summarized) 4. Weber-Dąbrowska B., Mulczyk M., Górski A. Bacteriophages as an efficient therapy for antibiotic- resistant septicemia in man. Transplant Proc. 2003; 35: 1385-1386. (94 cases were analyzed) Phage Therapy Unit Ludwik Hirszfeld Institute of Immunology and Experimental Therapy Polish Academy of Sciences, Weigla 12, 53-114 Wroclaw, Poland Head: prof. Andrzej Górski The Phage Therapy Unit at the Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, was opened at the end of 2005. According to Polish law, phage therapy is considered an experimental treatment which is carried out on the basis of the respective legislation (pharmacological law, regulations of the Minister of Health) and Declaration of Helsinki. Experimental treatment (or, translated literally, a therapeutic experiment) occurs when a physician introduces new or only partially tested diagnostic, therapeutic, or prophylactic methods for the direct benefit of the person being treated. In contrast, an investigational experiment has the primary purpose of broadening medical
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